Overview

A leading behavioral health practice faced considerable revenue losses due to reliance on county billing. Lacking the resources and expertise to manage payor enrollment in-house, they partnered with Knack RCM. Through a strategic approach, Knack facilitated successful enrollment with all targeted payors, increasing revenue and positioning the practice for sustainable growth and long-term stability.

Challenge

In 2024, this prominent behavioral health practice was experiencing substantial revenue losses despite its comprehensive service offerings—an impressive array of 70 programs across multiple locations—and its impact on the community. The core of the problem lay in its billing processes: Most of its facilities depended on county billing instead of establishing direct contracts with a broad range of governmental and commercial payors.

Efforts to tackle the issue internally were impeded by a lack of specialized knowledge and resources, leaving the practice unable to navigate the complexities of payor enrollment and capitalize on potential revenue streams. This financial bottleneck not only limited their income but also threatened to impede their ability to grow and expand their impact on the community.

Solution

The behavioral health practice contacted Knack RCM, which stepped in with a strategic, multi-step solution to unlock the practice’s revenue potential. This structured approach—focusing on three key steps—enabled Knack to manage the complex enrollment process seamlessly, turning a daunting challenge into a manageable, step-by-step project.

Foundation Building

The engagement began with a comprehensive conference call to collect essential documents and information about the practice and its providers. Knack then created detailed provider profiles in their credentialing system, laying the roundwork for successful enrollment.

Targeted Enrollment

With a solid foundation, Knack initiated enrollment, carefully selecting a tailored mix of payors to maximize revenue potential. This strategic selection ensured the practice could access lucrative reimbursement opportunities while minimizing administrative complications.

Ongoing Collaboration

Regular weekly conference calls were essential for keeping the project on track. This constant communication allowed Knack and the practice to address any challenges promptly, align on key milestones, and celebrate achievements as they
progressed.

Results

By entrusting the payor enrollment process to Knack RCM the behavioral health practice successfully enrolled with all targeted governmental and commercial payors. The financial impact was immediate and transformative:

0%
increase in gross revenue

This remarkable success has fundamentally changed the trajectory of the practice. Moving from a financially precarious position to one of stability and growth, they are now better equipped to invest in their staff, expand their service offerings, and strengthen their research initiatives. The practice’s newfound financial strength not only reversed its previous decline but also positioned it for sustainable, long-term success.

The practice is now poised to scale its impact even further. With a more robust financial foundation, it can extend its reach to serve more communities, offer more diverse services, and make a deeper impact on the lives of its patients.